Is it safe to get the Covid-19 vaccine while pregnant?
News of the arrival of the Covid-19 vaccine in Malaysia has also prompted abundant questions on its safety during pregnancy and lactation.
Prior observational data has demonstrated that while the chances for severe health effects are low, pregnant women with Covid-19 have an increased risk of severe illness including ICU admission, mechanical ventilation, and death compared to non-pregnant women of reproductive age.
At this point, only limited data is available on the safety of Covid-19 vaccines including mRNA vaccines administered during pregnancy.
The World Health Organisation (WHO) recently updated its advice on pregnant women receiving the vaccine, stating only those who are at high risk of contracting Covid-19 through work or who have underlying health
conditions which predispose them to develop complications from the virus, should take the vaccine.
On the other hand, The Centres for Disease Control and Prevention (CDC) has said that the vaccines should be available to those who are pregnant but ultimately leaves the decision up to expectant parents and their doctors.
In general, mRNA vaccines do not contain the live virus that causes Covid-19. Thus, theoretically it won't be able to give someone Covid-19. It does not interact with a person's DNA because the mRNA does not enter the nucleus of the cell.
Based on this, it is unlikely for the vaccine to pose a specific risk for those who are pregnant. However, the actual risks of mRNA vaccines to the pregnant woman and her foetus are unknown because these vaccines have not been studied in pregnant women.
One of the key considerations to note is that women who are pregnant and part of a group recommended to receive the Covid-19 vaccine, such as healthcare personnel, may choose to be vaccinated after thorough discussions with their doctor.
Another crucial discussion includes the risks of developing a severe allergic reaction balancing the benefits of vaccination itself.
The CDC recommends that all vaccine recipients, including those who are pregnant, talk to their healthcare provider if they have a history of severe allergic reactions, especially to another type of vaccine received previously.
Side effects can occur after receiving Covid-19 vaccines and these side effects are not expected to be any different in pregnant women as compared to non-pregnant women.
Pregnant women who experience fever following vaccination may be counselled to take paracetamol because fever has been associated with adverse pregnancy outcomes and paracetamol is considered relatively safe to be used in any trimester of pregnancy.
However, there is no data on the safety of Covid-19 vaccines in lactating women nor on the effects of mRNA vaccines on the breastfed infant or on milk production/excretion.
Again, women who are breastfeeding and are part of a group recommended to receive the Covid-19 vaccine, such as healthcare personnel, may choose to be vaccinated.
In conclusion, there is no evidence to suggest that any of the Covid-19 vaccines are likely to have adverse effects to either mum or baby and the data as well as recommendations on it have been contradictory.
However, in order to protect them from these risks, it is important that pregnant women receive safe and reliable advice when it comes to getting Covid-19 vaccines.
*The writer is an obstetrician and gynaecologist at Pantai Hospital Cheras (PHC).